Prevalence and correlates of bacterial vaginosis among young women of reproductive age in Mysore, India

Abstract

Purpose-Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge among women of childbearing age and is associated with STI/HIV and adverse birth outcomes. The objective of this study was to determine the prevalence and correlates of BV among young women of reproductive age in Mysore, India. Methods-Between October 2005 and December 2006, 898 sexually active women of 15-30 years of age were enrolled from two reproductive health clinics in Mysore. The women underwent an interview followed by physical examination, HSV-2 serologic testing, endocervical culture for Neisseria gonorrhoeae, and vaginal swabs for diagnosis of BV, Trichomonas vaginalis infection and candidiasis. Statistical analyses included conventional descriptive statistics and multivariable analysis using logistic regression.Results-Of the 898 women, 391 (43.5%) were diagnosed with ≥1 endogenous reproductive tract infection and 157 (17.4%) with ≥1 sexually transmitted infection. Only 863 women had Gram-stained vaginal smears available, out of which 165 (19.1, 95% confidence interval [CI]: 16.3%-22.2%) were found to have BV and 133 (15.4,.3%) were in the 'intermediate' stage. BV was related to concurrent infections with T. vaginalis (odds ratio [OR] = 4.07, 95% CI: 2.45-6.72) and HSV-2 seropositivity (OR = 2.22, 95% CI: 1.39-3.53).Conclusions-In this population, the prevalence of BV at 19% was relatively low. Coinfection with T. vaginalis, however, was common. BV was independently associated with concurrent T. vaginalis infection and partner's alcohol use. Muslim women had reduced odds of BV as compared to non-Muslim women. Further research is needed to understand the role of T. vaginalis infection in the pathogenesis of BV and the sociocultural context surrounding the condition in India. Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge among women of childbearing age and is associated with low birth weight infants (LBW) and preventable preterm births. Various studies across the world have shown that women with BV are more likely to be co-infected with herpes simplex virus type-2 (HSV-2), Trichomonas vaginalis, Neisseria gonorrhoeae and HIV. [1][2][3][4] Some studies have found a relationship between BV and high-risk behaviours associated with sexually transmitted infections (STIs) such as early sexual debut and multiple sex partners. [5] High co-infection rates with other STIs raise the possibility that BV may either increase susceptibility to STI or share a common pathway with other STIs. [1,4] BV is of special public health concern in India because of the high burden of reproductive and pregnancy-related morbidity. Research on BV in India is sparse and mainly limited to a few states. [6][7][8][9][10] To date, there are only two studies on the prevalence of BV in the state of Karnataka. [9,10] Because these studies had small sample sizes and one study diagnosed BV using Papanicolaou smears, [9] it is difficult to interpret the findings. This study examined the prevalence and potentially m...

Utility of Microbiological Profile of Symptomatic Vaginal Discharge in Rural Women of Reproductive Age Group

“…Maximum cases of symptomatic vaginal discharge were observed between 21 and 30 year of age (46%). Similar peak age incidence (15-30 years 82.8%) is noted in other studies done by Rekha et al, Singh et al, and Madhivanan et al, [1,8,9]. Out of 100 cases homogenous discharge was most prevalent (52%), followed by mucopurulant discharge in 23% of women.…”

The Epidemiology of Herpes Simplex Virus Type-2 Infection Among Pregnant Women in Rural Mysore Taluk, India

“…This is comparable to previously obtained measures of HSV-2 prevalence among other pregnant women in India [16,17]. The 6.7% prevalence is lower than the three previously obtained estimates of HSV-2 prevalence in the state of Karnataka, which ranged from 10.9 to 18.9% [20][21][22] although these studies focused on nonpregnant populations. Almost all the women in this study reported having a single sex partner in their lifetime and one woman reported being unmarried.…”

Diagnosis of Bacterial Vaginosis among Symptomatic Egyptian Women: Value of Assessing Bacterial Sialidase Activity

“…The prevalence of BV varied considerably (5 to 30%) among different studies (Bradshaw et al, 2005). Our observed prevalence was similar to those reported by Madhivanan et al, (2008), Akhter et al, (2010) and Mengistie et al, (2013) in India (19.1%), Bangladish (21%), and Ethiopia (19.4%), respectively. However, lower prevalence of BV was reported in France (7.1%) (Desseauve et al, 2012), Turkey (7.76%) (Haltas et al, 2012) and Pakistan (10.8%) (Taj et al, 2014).…”